A research team from the University of Bologna in Italy have published a new meta-anlaysis that explores the sequential integration of psychotherapy and pharmacotherapy in reducing the risk of relapse and recurrence in major depressive disorder.

They searched a range of databases for randomised controlled trials that tested the efficacy of the administration of psychotherapy after successful response to acute-phase pharmacotherapy in the treatment of adults with depression. They found 8 good quality trials, which when combined, involved 442 patients in a sequential treatment arm and 433 in a control treatment arm.

Their analysis turned up some promising results:

The pooled risk ratio (RR) for relapse/recurrence was 0.797 [95% confidence interval (CI) 0.659-0.964] according to the random-effects model, suggesting a relative advantage in preventing relapse/recurrence for the sequential administration of treatments compared with control conditions

Patients randomised to psychotherapy while antidepressants were discontinued were significantly less likely to experience relapse/recurrence compared to controls (RR 0.650, 95% CI 0.463-0.912).

The authors concluded:

We found evidence that the sequential integration of psychotherapy and pharmacotherapy is a viable strategy for preventing relapse and recurrence in major depressive disorder. In addition, our findings suggest that discontinuation of antidepressant drugs may be feasible when psychotherapy is provided.

André started the Mental Elf website in May 2011.
He has worked as an Information Scientist in Mental Health since the late nineties; initially at Oxford University's Centre for Evidence-Based Mental Health and since 2002 as the Managing Director of Minervation Ltd.
He loves blogging, social media and elves! He also has established interests in evidence-based healthcare, usability testing and web design.